Scrotal Pyocele Secondary to Perforated Appendicitis in Middle-Aged Man: A Case Report and Review of Literature.

A scrotal abscess following perforated appendicitis is a rare complication. This is mostly seen in children and usually occurs due to the presence of the patent processus vaginalis, which permits the passage of pus from the intra-abdominal cavity down to the scrotum, resulting in a scrotal pyocele. There are few reported cases of such complications in young adult patients. We report a case of a 50-year-old male with a scrotal pyocele following exploratory laparotomy for perforated appendicitis. Scrotal ultrasound (US) findings were suggestive of a right-sided scrotal abscess, and the CT scan showed prominent fat in the proximal part of the right inguinal canal, which suggested the presence of a partially patent processus vaginalis. Our case is the first reported in the middle-aged group, and our review of the literature is the first directed to the adult age group. This review emphasizes the importance of considering scrotal pyocele in any patient with acute scrotum post-appendectomy, regardless of the patient's age, the affected side, and the presence or absence of identifiable patent processus vaginalis, as it may be microscopically permeable. Treatment will entail urgent drainage of the abscess, together with a course of antibiotics.

Testicular Infarction in a Sickle Cell Hemoglobinopathy Patient: A Case Report.

Vaso-occlusive phenomena in sickle cell disease lead to ischemia and possible infarction of the affected organ. We report a case of a 20-year-old Saudi male known to have homozygous sickle cell hemoglobinopathy who was admitted to our institution with abdominal pain. One day post admission, the patient developed left testicular pain. Ultrasound showed decreased echogenicity, and Doppler examination showed absent blood flow in the left testicle. Left radical orchidectomy was done, and histopathological assessment revealed ischemic necrosis with sickled red blood cells (RBCs). A few studies have been reported worldwide suggesting that a vaso-occlusive event is the mainstay mechanism in such cases. This is the first case reported in the Eastern Province of Saudi Arabia.

A Case of Testicular Tumor Presenting as Acute Scrotum.

Germ cell tumors (GCTs) are the most common testicular malignancies in men. GCT typically presents as a painless nodule or swelling of the testicles with an atypical presentation such as heaviness or dull ache of the scrotum and/or the lower abdomen. Herein, we report a rare case of a testicular tumor presenting as an acute scrotum. This is a case of a 25-year-old male with no significant medical history; he presented to the emergency department with an acute scrotum for less than one day that was highly suspicious for testicular torsion. Surgical exploration and histopathology investigation revealed that this was a case of mixed GCTs.

Conservative Management of a COVID-19-positive Patient With Emphysematous Pyelonephritis: A Case Report.

Herein, we present a case of emphysematous pyelonephritis with septic shock that was treated conservatively. A 44-year-old woman with diabetes mellitus presented to the emergency department with acute abdominal discomfort. Clinical examination revealed that the patient was conscious but vitally unstable. Therefore, the patient required inotropic support. A computed tomography scan revealed gas in the left kidney, suggestive of emphysematous pyelonephritis. Subsequently, the patient was treated conservatively and stabilized with broad-spectrum antibiotics, strict blood glucose management, and drainage.